Liraglutide as Add-on to Oral Antidiabetic Agents or Insulin in Routine Practice of Patients with Type 2 Diabetes

摘要

Aims: To evaluate in a real-word routine-care practice the effect of liraglutide as add-on treatment in type 2 diabetic patients treated with oral antidiabetic agents and/or insulin. Methods: A retrospective study from 3 outpatient clinics in Copenhagen, Denmark, of all patients (n = 534) initiating treatment with liraglutide. 346 patients were treated ≥3 months. Excluded from analysis were: 107 patients changing from exenatide and 83 due to lack of clinical response or adverse events. Results: In 149 patients liraglutide was add-on to oral antidiabetic agents, most often metformin plus sulfonylurea (n = 86). Mean follow-up: 7.3 ± 3.0 months. HbA1c reduction: 1.3% ± 1.5% (15 ± 16 mmol/mol) from a baseline of 8.7% ± 1.5% (71 ± 16 mmol/mol). Weight reduction: –3.5 ± 4.9 kg from 105.2 ± 21.3 kg. Sulfonylurea treatment was stopped/dose reduced in 57% of these patients. In 114 patients liraglutide was add-on to insulin. Mean follow-up: 7.0 ± 3.1 months. HbA1c reduction: 0.8% ± 1.2% (8 mmol/mol) from a baseline of 8.7% ± 1.5% (71 ± 16 mmol/mol). Weight reduction: –5.1 ± 4.9 kg from 109.2 ± 22.1 kg. Baseline insulin dose of 83 ± 59 U/day was reduced by 28 ± 36 U/day. Insulin therapy could be stopped in 19% of these patients. Conclusions: Effects on HbA1c and weight of liraglutide as add-on to oral antidiabetic agents were not different from results previously published in randomised trials. Adding liraglutide to existing insulin regimens is an attractive treatment strategy in obese type 2 diabetic patients.